Group prenatal care for pregnant women with opioid use disorder: Preliminary evidence for acceptability and benefits compared with individual prenatal care.

INTRODUCTION: The effectiveness of group prenatal care (G-PNC) compared with individual prenatal care (I-PNC) for women with opioid use disorder (OUD) is unknown. The objectives of this study were to (1) assess the acceptability of co-locating G-PNC at an opioid treatment program and (2) describe the maternal and infant characteristics and outcomes of pregnant women in treatment for OUD who participated in G-PNC and those who did not. METHODS: This was a retrospective cohort study of 71 women (G-PNC n = 15; I-PNC n = 56) who were receiving treatment for OUD from one center and who delivered in 2019. Acceptability was determined by assessing the representativeness of the G-PNC cohorts, examining attendance at sessions, and using responses to a survey completed by G-PNC participants. The receipt of health services and healthcare use, behaviors, and infant health between those who participated in G-PNC and those who received I-PNC were described. RESULTS: G-PNC was successfully implemented among women with varying backgrounds (e.g., racial, ethnic, marital status) who self-selected into the group. All G-PNC participants reported that they were satisfied to very satisfied with the program. Increased rates of breastfeeding initiation, breastfeeding at hospital discharge, receipt of the Tdap vaccine, and postpartum visit attendance at 1-2 weeks and 4-8 weeks were observed in the G-PNC group compared with the I-PNC group. Fewer G-PNC reported postpartum depression symptomatology. CONCLUSION: Findings suggest that co-located G-PNC at an opioid treatment program is an acceptable model for pregnant women in treatment for OUD and may result in improved outcomes.

A Learning Community Supporting Experiential Education to Learn About Healthcare Equity Quality Improvement.

BACKGROUND: Quality improvement (QI) for healthcare equity (HCE) is an important aspect of graduate medical education (GME), but there is limited published research on educational programs teaching this topic. AIM: To describe and evaluate a novel curriculum and learning community for HCE QI. SETTING: Academic institution. PARTICIPANTS: Forty-eight participants: 32 learners and 16 faculty. PROGRAM DESCRIPTION: This novel, longitudinal curriculum utilized a virtual hub-and-spoke learning community. Five interdepartmental teams of learners and faculty (spokes) used QI methods to address an existing institutional healthcare inequity (HCI). A team of experts (the hub) led monthly group meetings to foster the learning community and guide teams. PROGRAM EVALUATION: Retrospective pre-post curricular surveys assessed participant satisfaction, knowledge, and skills in applying QI methods to address HCIs. Response rate was 33%. The majority of participants (92.4%) reported an increase in knowledge and skills in conducting QI for HCIs. All participants reported an increased likelihood of future engagement in HCE QI. Final QI projects average QIPAT7 score was 25.8 (SD = 4.93), consistent with "meets expectations" in most categories. DISCUSSION: This program is a feasible model to teach GME learners and faculty about HCE QI and may be adopted by other institutions.